Individual provider Active NPI

Christine Grace Reilly, RN

  • Registered Nurse
  • Lakewood, CO
National Provider Identifier
1346584240
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0195676 Issued in CO
Practice address
645 Parfet St
Lakewood, CO 80215-5574
Phone
(303) 239-7138
Fax
(303) 239-7088
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0195676 CO Primary

Addresses

Primary practice location

645 Parfet St
Lakewood, CO 80215-5574

Mailing address

645 Parfet St
Lakewood, CO 80215-5574
Phone (303) 239-7138

Other practice location 1

645 Parfet St
Lakewood, CO 80215-5574
Phone (303) 239-7138

Other identifiers 1

IdentifierTypeStateIssuer
14489511MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0195676COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Colorado PastSince Dec 16, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1346584240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 PARFET ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802155574",
            "telephone_number": "303-239-7138",
            "fax_number": "303-239-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 PARFET ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802155574",
            "telephone_number": "303-239-7138",
            "fax_number": "303-239-7088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "645 Parfet St",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802155574",
            "country_code": "US",
            "telephone_number": "303-239-7138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILLY",
        "first_name": "CHRISTINE",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0195676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14489511",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.